Pregnancy in the time of COVID-19: towards Fetal monitoring 4.0

Abstract

On the outbreak of the global COVID-19 pandemic, high-risk and vulnerable groups in the population were at particular risk of severe disease progression. Pregnant women were one of these groups. The infectious disease endangered not only the physical health of pregnant women, but also their mental well-being. Improving the mental health of pregnant women and reducing their risk of an infectious disease could be achieved by using remote home monitoring solutions. These would allow the health of the mother and fetus to be monitored from the comfort of their home, a reduction in the number of physical visits to the doctor and thereby eliminate the need for the mother to venture into high-risk public places. The most commonly used technique in clinical practice, cardiotocography, suffers from low specificity and requires skilled personnel for the examination. For that and due to the intermittent and active nature of its measurements, it is inappropriate for continuous home monitoring. The pandemic has demonstrated that the future lies in accurate remote monitoring and it is therefore vital to search for an option for fetal monitoring based on state-of-the-art technology that would provide a safe, accurate, and reliable information regarding fetal and maternal health state. In this paper, we thus provide a technical and critical review of the latest literature and on this topic to provide the readers the insights to the applications and future directions in fetal monitoring. We extensively discuss the remaining challenges and obstacles in future research and in developing the fetal monitoring in the new era of Fetal monitoring 4.0, based on the pillars of Healthcare 4.0.

COVID-19 Distribution in Pregnancy, Drug Use Patterns and COVID-19 Medication during the Pandemic in Spain: Data from Real-World Electronic Health Records

“…In terms of drug utilization, we observed that a total of 72% of pregnant women with COVID-19 received a prescription, and 66.6% among women without COVID-19. Although there have been several factors that might affect the rates of drug prescriptions during the pandemic, such as public health policies, limited or inadequate healthcare prenatal visits, change in birth plan, limited care, quarantine and mobility restrictions [ 25 , 26 , 27 , 28 ], our results are in line with prior studies conducted before the COVID-19 outbreak, where they found a wide range in prevalence of receiving at least one prescription, from 27 to 93% [ 14 ]. The most relevant therapeutic groups prescribed in our study were analgesics (especially acetaminophen), antibiotics and thyroid hormones, in line with prior studies [ 29 , 30 , 31 , 32 , 33 ].…”

Optimal Oxygen Therapy Strategies for COVID-19 Positive Pregnant Women: A Comprehensive Review

“…Continuous monitoring of FHR via cardiotocography (CTG) or electronic fetal monitoring provides insight into fetal well-being. 17 Hypoxemia in the mother can compromise fetal oxygenation, affecting the FHR.…”

Tracking Pregnancy Complications and Engagement with Remote Patient Monitoring in Prenatal Care: Retrospective Review (Preprint)

“…[5][6][7][8] The COVID-19 pandemic accelerated the use of RPM, digital health tools, and telemedicine across a wide variety of medical fields with potential benefits including a reduced time to diagnosis and improved access to specialist care. [8][9][10][11][12][13][14] In addition, remote technology allows for higher-frequency data collection compared to traditional in-person office visits. 13 The increased data collection has the potential to lead to more accurate predictors of pregnancy complications and provide more timely feedback to physicians and patients.…”

“…[8][9][10][11][12][13][14] In addition, remote technology allows for higher-frequency data collection compared to traditional in-person office visits. 13 The increased data collection has the potential to lead to more accurate predictors of pregnancy complications and provide more timely feedback to physicians and patients. 15,16 The objective of this study was to describe the prenatal care and pregnancy outcomes in patients who used the Babyscripts™ prenatal care digital health platform and identify predictors of RPM engagement and complications of pregnancy.…”